Onychodystrophy in Sézary syndrome

Damasco, Fabiana; Geskin, Larisa J.; Akilov, Oleg E.

doi:10.1016/j.jaad.2018.06.023

Cited by 5 publications

(5 citation statements)

References 5 publications

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“…Clinical findings are summarized in Table 2. Previously published cluster analysis 8 of our data in comparison with published data on nail psoriasis 9-12 indicated that while leukonychia, onycholysis, and subungual hyperkeratosis are frequently observed in psoriasis, onychauxis, anonychia, distal notching, and onychoschizia are quite characteristic for SzS as well. Thus, the most specific onychodystrophies in patients with SzS are illustrated in Figure 2.…”

Section: Resultssupporting

confidence: 64%

Nail Changes in Sézary Syndrome: A Single-Center Study and Review of the Literature

2019

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Background: The onychodystrophies associated with Sézary syndrome (SzS) have rarely been described in the literature. We performed a retrospective analysis of SzS patients at a single institution and compared our data with previous publications. Objectives: The objectives of this study were to identify and describe the most frequent nail alterations in patients with SzS. Methods: A retrospective analysis was performed with some prospective observations at the University of Pittsburgh from 1989 to 2017. Results: We identified 54 patients with SzS out of 535 patients with cutaneous T-cell lymphoma. Nineteen patients with SzS had photos of their nail. All those patients exhibited some type of onychodystrophy. The most common types were paronychia (63.2%; 12/19), leukonychia (42.1%; 8/19), onycholysis (42.1%; 8/19), trachyonychia (31.6%; 6/19), and subungual hyperkeratosis (26.3; 5/19). Cluster analysis of our data in comparison with published data on the psoriatic nails indicated that while leukonychia, onycholysis, subungual hyperkeratosis, and nail discoloration were frequently observed in psoriasis, onychauxis, anonychia, distal notching, and onychoschizia occurred more commonly in patients with SzS. Conclusions: The most common nail manifestations in SzS patients included paronychia, leukonychia, and onycholysis. The nail manifestations in SzS patients appeared to be heterogeneous, while onychauxis, anonychia, distal notching, and onychoschizia seem to be specific to SzS in comparison with psoriasis.

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Section: Resultssupporting

confidence: 64%

Nail Changes in Sézary Syndrome: A Single-Center Study and Review of the Literature

2019

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“…We observed a higher frequency of nail alterations in erythrodermic www.nature.com/scientificreports www.nature.com/scientificreports/ psoriasis (83.3%), and they include subungual hyperkeratosis, pitting, onycholysis, and oil drop sign. Damasco et al reported paronychia, leukonychia, and onycholysis as the most common nail manifestations in SS 44 . We observed subungual hyperkeratosis, onycholysis, and shiny nails from scratching the skin due to severe pruritus.…”

Section: Clinical Findingsmentioning

confidence: 99%

Erythroderma: a prospective study of 309 patients followed for 12 years in a tertiary center

Miyashiro

Sanches

2020

Sci Rep

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Erythroderma is characterized by erythema and scaling affecting more than 80% of the body surface area. It is potentially life-threatening, and diagnosis of the underlying disease is a challenge. Despite laboratory improvements, many cases remain idiopathic. We aimed to analyze clinical and laboratory findings of 309 erythrodermic patients to find clues to the etiologic diagnosis. We performed a prospective study at the University of São Paulo Medical School, from 2007 to 2018, with patients with acquired erythroderma. Clinical, laboratory, histology, and molecular biology data were collected. The median age at diagnosis was 57 years, with a male-to-female ratio of 2.2. Eczema was the most frequent etiology (20.7%), followed by psoriasis (16.8%), Sézary syndrome (12.3%), drug eruption (12.3%), atopic dermatitis (8.7%), and mycosis fungoides (5.5%). Other diagnoses (6.8%) included pemphigus foliaceous, paraneoplastic erythroderma, adult T-cell leukemia/lymphoma, dermatomyositis, pityriasis rubra pilaris, lichen planus, bullous pemphigoid, and leprosy. In 52 patients (16.8%), it was not possible to elucidate erythroderma etiology. Atopic dermatitis developed erythroderma at an earlier age (median 25 years; P = 0.0001). Acute onset was associated with drug reactions and atopic dermatitis (median time from erythroderma to diagnosis of 1 and 1.5 months, respectively; P = 0.0001). Higher immunoglobulin E levels were observed in atopic dermatitis (median 24,600 U/L; P = 0.0001). Histopathology was helpful and was consistent with the final diagnosis in 72.4%. Monoclonal T-cell proliferation in the skin was observed in mycosis fungoides (33.3%) and Sézary syndrome (90.9%). At the last assessment, 211 patients (69.3%) were alive with disease, 65 (21.7%) were alive without disease, and 27 (9.1%) died with active disease. Erythroderma is a challenging syndrome with a difficult diagnostic approach. Younger age and higher immunoglobulin E levels are associated with atopic dermatitis; acute onset is observed in drug eruptions and atopic dermatitis. Histopathology and molecular biology tests are essential tools in the investigation of erythroderma.

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“…However, it should be underscored that patients with CTCL were significantly older than participants with psoriasis, AD or PRP. It is worth noting that trachyonychia (20-nail dystrophy), which was initially associated with advanced Sezary syndrome, [7][8][9] was also observed in two participants with CTCL in the current study. Pityriasis rubra pilaris is known to associated with nail dystrophy.…”

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confidence: 51%

Nail unit dermoscopy (onychoscopy) in the differential diagnosis of erythroderma

Żychowska

Tognetti

2023

Acad Dermatol Venereol

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Onychodystrophy in Sézary syndrome

Cited by 5 publications

References 5 publications

Nail Changes in Sézary Syndrome: A Single-Center Study and Review of the Literature

Nail Changes in Sézary Syndrome: A Single-Center Study and Review of the Literature

Erythroderma: a prospective study of 309 patients followed for 12 years in a tertiary center

Nail unit dermoscopy (onychoscopy) in the differential diagnosis of erythroderma

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